§Why CasetextPricing

Benjamin v. Oxford Health Ins, Inc

MOTION for Summary Judgment

15 Cited authorities

  1. Firestone Tire Rubber Co. v. Bruch

    489 U.S. 101 (1989)   Cited 8,907 times   54 Legal Analyses
    Holding that a denial of ERISA benefits "is to be reviewed under a de novo standard unless the benefit plan gives the administrator or fiduciary discretionary authority to determine eligibility for benefits or to construe the terms of the plan"

  2. U.S. Airways, Inc. v. McCutchen

    569 U.S. 88 (2013)   Cited 349 times   32 Legal Analyses
    Holding equitable principles cannot override clear plan terms

  3. Abatie v. Alta Health Life Ins. Co.

    458 F.3d 955 (9th Cir. 2006)   Cited 1,142 times   4 Legal Analyses
    Holding that limiting the judicial record to that before the plan administrator is not appropriate in de novo cases

  4. Kinstler v. First Reliance Standard Life Ins. Co.

    181 F.3d 243 (2d Cir. 1999)   Cited 383 times   3 Legal Analyses
    Holding de novo review applies to plan administrator's fact-based determination in absence of plan language granting discretionary authority

  5. Orndorf v. Paul Revere Life Ins. Co.

    404 F.3d 510 (1st Cir. 2005)   Cited 269 times
    Holding that a court should make a review of the plan fiduciary's decision

  6. Harlick v. Blue Shield of Cal.

    686 F.3d 699 (9th Cir. 2012)   Cited 151 times   4 Legal Analyses
    Holding that the terms of the insurance plan itself did not require the insurer to pay for the plaintiff's care at a residential treatment facility for her anorexia but that the California Mental Health Parity Act did require such

  7. Locher v. Unum Life Ins. Co. of America

    389 F.3d 288 (2d Cir. 2004)   Cited 169 times   3 Legal Analyses
    Holding that "a conflicted administrator does not per se constitute good cause" and clarifying that DeFelice based its "holding not only on a demonstrated conflict of interest, but also upon the procedural problems with the plan administrator's appeals process"

  8. Mitchell v. CB Richard Ellis Long Term Disability Plan

    611 F.3d 1192 (9th Cir. 2010)   Cited 62 times
    Finding the "2008 market rate for plaintiff-side partner-level ERISA attorneys is $400-$575/hour"

  9. Lauder v. First Unum Life Ins. Co.

    284 F.3d 375 (2d Cir. 2002)   Cited 80 times
    Holding that whether the district court correctly calculated damages is a question that we review de novo

  10. Rule 56 - Summary Judgment

    Fed. R. Civ. P. 56   Cited 335,322 times   160 Legal Analyses
    Holding a party may move for summary judgment on any part of any claim or defense in the lawsuit

  11. Section 1001 - Congressional findings and declaration of policy

    29 U.S.C. § 1001   Cited 20,723 times   59 Legal Analyses
    Noting that ERISA was enacted “to protect ... employee benefit plans and their beneficiaries”

  12. Section 1104 - Fiduciary duties

    29 U.S.C. § 1104   Cited 4,916 times   73 Legal Analyses
    Specifying duties of a "fiduciary . . . with respect to a plan"

  13. Section 1133 - Claims procedure

    29 U.S.C. § 1133   Cited 2,365 times   13 Legal Analyses
    Affording claimants "a reasonable opportunity ... for a full and fair review" after denial of a claim for benefits

  14. Section 1102 - Establishment of plan

    29 U.S.C. § 1102   Cited 1,643 times   12 Legal Analyses
    Granting administrator, as “named fiduciary,” the “authority to control and manage the operation and administration of the plan”

  15. Section 2560.503-1 - Claims procedure

    29 C.F.R. § 2560.503-1   Cited 2,879 times   78 Legal Analyses
    Adopting the requirements of 29 C.F.R. § 2560.503-1